Relationship between psoriatic arthritis and moderate–severe psoriasis: analysis of a series of 166 psoriatic arthritis patients selected from a hospital population

Abstract

The aim of the study was to assess the prevalence of moderate to severe psoriasis (MS-P) in patients with psoriatic arthritis (PsA) and the relationship between MS-P and other variables related to arthritis. One hundred sixty-six consecutive patients with PsA periodically monitored at a university hospital's PsA unit in northeastern Spain were included in the study. Patients with psoriasis were classified as having MS-P when systemic treatment for skin was required. Clinical criteria for treatment indication was BSA >10 and/or PASI >14 and/or psoriasis affecting a very sensitive area of the body. Demographic and clinical data related to arthritis were assessed, including PsA pattern, age of onset of psoriasis and arthritis, disease activity index, and treatment required over the course of the disease. Moderate-severe psoriasis were more prevalent in women (p = 0.027). One hundred nine patients (65.7%) had psoriatic nail disease, and MS-P was more frequent in these patients (40 (77%) vs. 69 (61%), p = 0.028). Patients with spondyloarthropathy were significantly associated with MS-P (7 (16%) vs. 3 (3%), p = 0.014). No statistical association was observed between severe psoriasis and the age of onset of psoriasis or arthritis, involvement of distal interphalangeal joints, laboratory findings (HLA B27, RF), functional class, or disease activity indices. We report a high prevalence of severe psoriasis among patients with psoriatic arthritis, higher in women and patients with psoriatic nail disease and axial spondyloarthropathy.

Arthritis as an important determinant for psoriatic patients to develop severe vascular events in Taiwan: a nation‐wide study

“…In addition, it has been shown that effective systemic therapy may ameliorate cardiovascular risk profiles of psoriatic patients 26,27 . As mentioned previously, psoriatic patients with arthritis were associated with higher PASI scores and higher CRP levels as compared with those without 19,21 . Therefore, methotrexate treatment may reduce the risks for developing severe vascular complications in certain subsets of psoriatic patients with less severe systemic inflammatory status.…”

“…26,27 As mentioned previously, psoriatic patients with arthritis were associated with higher PASI scores and higher CRP levels as compared with those without. 19,21 Therefore, methotrexate treatment may reduce the risks for developing severe vascular complications in certain subsets of psoriatic patients with less severe systemic inflammatory status. Our database, however, does not contain information on severity of disease to validate this hypothesis.…”

“…Several studies had shown that psoriatic patients with joint involvements are more likely to have more severe disease course. Psoriatic patients with arthritis were reported to have higher psoriasis activity and severity index (PASI) scores 19 and lower quality of life 20 than those without. Serum levels of highly sensitive CRP were also reported to be higher in psoriatic patient with joint involvement 21 .…”

A head-to-head comparison of the efficacy and safety of ixekizumab and adalimumab in biological-naïve patients with active psoriatic arthritis: 24-week results of a randomised, open-label, blinded-assessor trial

“…Although skin involvement is usually mild in patients with PsA, clinicians and patients judge the impact of a PsA treatment by effects on all domains affected by the disease, in particular joints and skin 20–22. Furthermore, achievement of optimal health-related quality of life, the ultimate treatment goal in PsA, requires improvements in both joint and skin manifestations of the disease 1.…”

Axial psoriatic arthritis: an intriguing clinical entity or a subset of an intriguing disease?

“…To address this point, very recently, a Spanish study showed that, among a group of PsA patients, the subgroup with SpA was significantly associated with moderate to severe psoriasis [13]. Finally, a study aimed to describe differential characteristics of axial involvement in AS compared with that seen in PsA and inflammatory bowel disease (IBD) in a cohort of patients.…”